By Marianne Simon,
PsyD-Director of Behavioral and Therapeutic Supports
The hallmark characteristics of Autism Spectrum Disorder (ASD) are difficulties with communication and restrictive or repetitive behavior patterns. Data from the Center for Disease Control (CDC) notes that in 2016, approximately 1 in 54 children had been diagnosed with an ASD by the age of 8 years old. Additionally, 84% of children had a developmental screening by age 3, which is a 10% increase from previous reports (CDC, 2020). The marked increase in early screenings and diagnosis at an earlier age is evidence that the field has made tremendous progress focusing on early intervention. It is widely recognized that earlier diagnosis and treatment leads to better outcomes for individuals on the Spectrum. The past 14 months, however, have certainly presented a challenge for families in accessing evaluations and interventions.
As a result of the COVID-19 pandemic, schools, daycares, and educational centers shut down. Social and recreational activities were at a halt for over a year. We as a nation were experiencing extreme social isolation. This has lead to the diagnosis of ASD being impacted by the pandemic in multiple ways. First, parents or caregivers who noticed atypical development or behavioral concerns in their children may be unsure if this was a reaction to the social isolation, or if it may be an indicator of neurodevelopmental issues. Children may have been exhibiting more extreme behaviors due to the stress and anxiety of routines being significantly impacted. Or, on the other end, due to the isolation, caregivers may have missed the red flags or early indicators, because it is often others outside of the immediate family (such as daycare providers or extended family members) who are the first to notice early warning signs such as delays in social communication or repetitive behavior patterns.
Further, even if parents or caregivers identified there was a concern, the pandemic impacted the ability to access a comprehensive evaluation. A big piece of an ASD assessment is being able to observe the child and how they interact with their environment and others. Some professionals were relying on video conferencing to remotely interview parents and observe the child in their home environment, or having parents record different parts of the child’s day. However, not all families had access to the technology to participate in such telehealth appointments. Other clinicians may have been able to have families come to their clinic for evaluation, yet masks was presenting another challenge. As an evaluator you want to be able to see the child’s facial expressions and observe their reactions.
It will not be known for years how exactly the last 14 months will impact future prevalence rates of ASD. However, it is important for families to continue to bring any developmental concerns they have to their primary care physician and from there, together they can determine if a referral to a developmental pediatrician is necessary.
References: CDC (2020). National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention.